Insurance Fraud

Insurance fraud falls into two broad categories:  
1)    Fraud committed by an insured person.
2)    Fraud committed by an insurance company, including agents and brokers.

Insurance fraud can be a federal crime (for example, defrauding Medicare in health care benefit programs) and/or a state crime both of which can result in a fine, a prison sentence, or a combination thereof, especially in cases involving a violation of federal law via the wire fraud or mail fraud statutes.

There are two types of insurance fraud committed by an insured:
1)    Legitimate insurance claims with exaggerated damages.
2)    Fake claims for damages that never occurred or were staged.

The most common types of insurance fraud schemes committed by an insured relate to car insurance, health insurance, life insurance or property insurance.  It is suspected that up to a third of all car insurance claims have an element of fraud.  Car insurance fraud includes staging accidents/car theft, exaggerating or inventing personal injuries/repair costs, registering a car in a state with lower insurance premiums, falsifying wage loss, registering a lower premium driver as a primary driver, etc.  

Examples of health insurance fraud are billing for a different treatment to cover up a treatment not covered under the patient’s insurance policy, billing for a more expensive treatment, billing for an unnecessary treatment, billing for a treatment that was never given, etc.  Life insurance fraud includes staging a fake death to covering up a suicide as an accident.  Most common property insurance fraud involves arson of a property with low chance of sales, arson of unsold/old inventories, falsifying the amount of lost/damage, etc.   

Insurance fraud committed by an insurance company includes:
1)    Sales of insurance products by misrepresentation, sales of unlicensed insurance products, sale of fake insurance coverage, etc.
2)    Charging extra insurance premiums.
3)    Outright theft of insurance premiums by insurance agents or brokers.

If you are charged with any form of insurance fraud or believe you are under investigation for an insurance fraud, please contact an attorney as soon as possible.  Do not make any statements to law enforcement, which can be used against you later.  We will strive to defend your rights zealously within the bounds of the law in dealing with any federal and serious state felony charges, and our experienced attorneys are available anytime – 24 hours, 7 days/week – to discuss your case.  The first consultation is always free of charge.